A text-book of practical obstetrics, comprising pregnancy, labor, and the puerpal state, and obstetric surgery . t of pressure is necessary to prevent the bladesslipping, but by relaxing the grasp frequently the injury to thechild will be greatly lessened. As soon as the forehead is madeto appear beneath the pubic arch it is well to remove the for-ceps, and, unless the reasons for immediate extraction areurgent, it is well to give nature a chance to rotate the occiput 86 OBSTETRIC SURGERY. anteriorly. Otherwise, in place of making traction horizontally,as is necessary when bringing the forehea
A text-book of practical obstetrics, comprising pregnancy, labor, and the puerpal state, and obstetric surgery . t of pressure is necessary to prevent the bladesslipping, but by relaxing the grasp frequently the injury to thechild will be greatly lessened. As soon as the forehead is madeto appear beneath the pubic arch it is well to remove the for-ceps, and, unless the reasons for immediate extraction areurgent, it is well to give nature a chance to rotate the occiput 86 OBSTETRIC SURGERY. anteriorly. Otherwise, in place of making traction horizontally,as is necessary when bringing the forehead underneath thepubic arch, the handles should be lowered as far as the peri-neum will permit. This manoeuvre will cause marked extensionof the head and the forehead will be brought underneath thepubic rami. Forced extension now will cause the forehead toclear the pubes. The forceps should now be removed and, pass-ing two fingers into the rectum, the head should be flexed untilthe occiput escapes over the perineum. Laceration of the perineum will be almost certain to occur,and it should be repaired at Fig. 41.—Showing Direction of Traction in Face Presentation. As already stated, these cases are among the most diffi-cult ones found in obstetrics, and one of the hardest things toresist is the desire to attempt instrumental rotation. It willonly be necessary to remember to what unusual risks this willsubject the mother, to deter one from this procedure. Low Forceps in Face Presentations.—The application offorceps in face presentations, when that condition has not beendiagnosed until after the face is well down in the pelvic canal,should be delayed as long as is consistent with the safety ofmother and child, in order that anterior rotation of the chinmay occur. This rotation is nearly always tardy, and some-times does not take place at all. Manual rotation of the head,if not too firmly wedged, is permissible and sometimes success- FORCEPS. 87 ful, but at no time should
Size: 1982px × 1261px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1800, bookdecade1890, bookpubli, booksubjectobstetrics
